Covid-19 and mental health : Strategies to mitigate fear and anxiety
Photo Credit: For representational purpose only
As news about the coronavirus outbreak continues to dominate the headlines and millions of people all over the world are being asked to self-quarantine, it has become increasingly significant to pay as much attention to our mental health as we do to our physical health. The rising incidents of growing depression, anxiety , ocds , suicide and other mental health problems has raised concerns both for the government and health professionals. The number of patients in psychiatry out patient department has increased drastically since last one month with more patients of anxiety, insomnia & depression coming. Patients complaining of not able to access care is also coming from different parts of country as regular opds are shut in various hospitals to avoid suspected risk of infection. Anxiety and depression are equalised in the age of Corona. People with mental issues are finding it fascinating while those who loves socialising physically are unable to sole through the boredom. With lockdowns everywhere things have taken a 360 degree change and will not remain the same as it was pre-Corona era.
With nearly 4500 people in India having fallen prey to the corona infection ,the situation seems grim.To add to this burden is the growing incidence of mental health problems as highlighted below-
- Anxiety related issues like palpitations, tremors, episodes of breathlessness unrelated to cardiac and respiratory illnesses, feeling of impending doom.Such kind of panic attacks are being frequently observed in the predisposed groups.People with preexisting mental heath issues are at the highest risk.
- Depressive disorders manifesting as sad mood, low body energy, headaches, feelings of self harm and disturbing sleep and appetite are amplified by the present situation.
- Obsessive and compulsive disorder evident clinically commonly as excessive concerns for cleanliness and thereafter repeated cleaning will see a large fold rise after the corona pandemic is over.
- Substance related issues like harmful use of opioids,alcohol and street drugs like cannabis are and will be on the rise in persons with above three psychiatric issues to cope with these issues.
- Sleep related problems most common of which is lack of sleep is being faced by many among us today is another health burden as reduced sleep proportionately increases chances of hypertension,uncontrolled diabetes which are further responsible for corona related deaths.
- The baap of all are the psychotic disorders presenting as abrupt onset of hallucinations, suspiciousness,fearfullness that the world is coming to an end and I may die soon, violence and aggression,,such disorders are already evident to many of our psychiatry collegues.
- Suicide and self harm are being adopted as a coping mechanism to all the above mental health issues (1-6) by many people especially seen in the patients who have provisional symptoms of covid19,;cases reported in the media too.Few of these suspected patients turned out to be corona negative that was revealed after the commission of suicide.
- Children too might face the brunt of this pandemic once they grow up.Personality issues will surely be observed in these cases.
By writing this in detail my aim is not to instill fear among the masses but to make all aware of the fact that how deadly can the outcomes of this pandemic can be.With this I want to highlight the importance of mental health which has been ignored since ages both by our society and by our politicians, law makers and law enforcers.Let us all realise the fact that it is high time to remove the stigma related to psychiatric diseases and start practising some mental health hygiene measures in our day to day lives and never feel shy or hesitation in seeking help from a psychiatrist.
Minimize watching, reading or listening to news about COVID-19 that causes you to feel anxious or distressed; seek information only from trusted sources and mainly so that you can take practical steps to prepare your plans and protect yourself and loved ones. Seek information updates at specific times during the day, once or twice. The sudden and near-constant stream of news reports about an outbreak can cause anyone to feel worried. Get the facts; not rumours and misinformation. Gather information at regular intervals from the WHO website and local health authority platforms in order to help you distinguish facts from rumours. Facts can help to minimize fears.
Protect yourself and be supportive to others. Assisting others in their time of need can benefit both the person receiving support and the helper. For example, check by telephone on neighbours or people in your community who may need some extra assistance. Working together as one community can help to create solidarity in addressing COVID-19 together.
Find opportunities to amplify positive and hopeful stories and positive images of local people who have experienced COVID-19. For example, stories of people who have recovered or who have supported a loved one and are willing to share their experience.
Honour carers and healthcare workers supporting people affected with COVID-19 in your community. Acknowledge the role they play in saving lives and keeping your loved ones safe.
Help children find positive ways to express feelings such as fear and sadness. Every child has his or her own way of expressing emotions. Sometimes engaging in a creative activity, such as playing or drawing can facilitate this process. Children feel relieved if they can express and communicate their feelings in a safe and supportive environment.
Keep children close to their parents and family, if considered safe, and avoid separating children and their carers as much as possible. If a child needs to be separated from his or her primary carer, ensure that appropriate alternative care is provided and that a social worker or equivalent will regularly follow up on the child. Further, ensure that during periods of separation, regular contact with parents and carers is maintained, such as twice-daily scheduled telephone or video calls or other age-appropriate communication (e.g. social media).
Maintain familiar routines in daily life as much as possible, or create new routines, especially if children must stay at home. Provide engaging age-appropriate activities for children, including activities for their learning. Where possible, encourage children to continue to play and socialize with others, even if only within the family when advised to restrict social contact.
During times of stress and crisis, it is common for children to seek more attachment and be more demanding on parents. Discuss COVID-19 with your children in an honest and age-appropriate way. If your children have concerns, addressing them together may ease their anxiety. Children will observe adults’ behaviours and emotions for cues on how to manage their own emotions during difficult times.
For health care workers-Take care of yourself at this time. Try and use helpful coping strategies such as ensuring sufficient rest and respite during work or between shifts, eat sufficient and healthy food, engage in physical activity, and stay in contact with family and friends. Avoid using unhelpful coping strategies such as use of tobacco, alcohol or other drugs. In the long term, these can worsen your mental and physical well-being. The COVID-19 outbreak is a unique and unprecedented scenario for many workers, particularly if they have not been involved in similar responses. Even so, using strategies that have worked for you in the past to manage times of stress can benefit you now. You are the person most likely to know how you can de-stress and you should not be hesitant in keeping yourself psychologically well. This is not a sprint; it’s a marathon. With collective efforts , India will surely win the battle & emerge stronger.
About the author
Dr. Piyush Mahajan is a mental health specialist and awarded with a gold metal in psychiatry by Baba Farid University of Health Sciences. He is presently working as a senior resident in Psychiatry at Sri Guru Ramdas Medical College, Vallah, Amritsar . Dr Mahajan has initiated telephonic services to assist all suffering from mental health stigma during Corona Crisis. He can be contacted at 9888689299.
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